Anatomy

Question 1

What is the function of the iliohypogastric nerve

Answer 1

The iliohypogastric nerve originates from the first ventral rami in the lumbar plexus. It supplies motor innervation to the transversus abdominis and the internal oblique muscles.

Question 2

How is the conjoint tendon formed

Answer 2

The conjoint tendon is formed from the lower part of the common aponeurosis of the abdominal internal oblique muscle and the transversus abdominis muscle.

Question 3

What muscles attach into the iliotibial band

Answer 3

Gluteus maximus and TFL

Question 4

What are the boundaries of the posterior mediastinum

Answer 4

Lateral: Mediastinal pleura (part of the parietal pleural membrane). Anterior: Pericardium. Posterior: T5-T12 vertebrae

Question 5

What are the contents of the posterior mediastinum

Answer 5

Azygous vein, Thoracic aorta, Thoracic duct, oesophagus, sympathetic plexus.

Question 6

What are the layers of the oesophagus

Answer 6

Adventitia – outer layer of connective tissue.
Note: The very distal and intraperitoneal portion of the oesophagus has an outer covering of serosa, instead of adventitia.
Muscle layer – external layer of longitudinal muscle and inner layer of circular muscle. The external layer is composed of different muscle types in each third:
Superior third – voluntary striated muscle
Middle third – voluntary striated and smooth muscle
Inferior third – smooth muscle
Submucosa
Mucosa – non-keratinised stratified squamous epithelium (contiguous with columnar epithelium of the stomach).

Question 7

What is achalasia

Answer 7

Achalasia is an esophageal smooth muscle motility disorder that occurs due to a failure of relaxation of the lower esophageal sphincter.

Question 8

How long does Vicryl last

Answer 8

3-4 weeks

Question 9

How long does monocryl last

Answer 9

20 days

Question 10

Why is prolene blue

Answer 10

To enhance visibility

Question 11

What is the prostatic urethra

Answer 11

The prostatic utricle is a small blind-ending sac, a vestigial structure that is the homologue of the uterus. On either side of this (not seen in the photography) is the slit-like opening of the ejaculatory ducts.

Question 12

Where do the hip bones meet

Answer 12

The ilium, ischium and pubis meet in the acetabulum (meaning ‘vinegar cup’) to form a ‘Mercedes’ symbol

Question 13

What are the boundaries of the anatomical snuffbox

Answer 13

Proximal = radial styloid process.
Distal = base of 1st metacarpal.
Floor = scaphoid and trapezium.
Medial = extensor pollicis longus.
Lateral = abductor pollicis longus and extensor pollicis brevis.

Question 14

What lies between the stomach and the pancreas

Answer 14

The lesser sac

Question 15

What is the relation of the duodenum to the peritoneum

Answer 15

Except for the first segment, the rest of the duodenum is retroperitoneal

Question 16

What lies behind and in front of D3

Answer 16

The inferior duodenum travels laterally to the left, crossing over the inferior vena cava and aorta. It is located inferiorly to the pancreas, and posteriorly to the superior mesenteric artery and vein.

Question 17

What are the 2 heads of the pec major and where do they originate

Answer 17

Clavicular head: Originates from the anterior surface of the medial half of the clavicle
Sternocostal head: Originates from the anterior surface of the sternum, the first seven costal cartilages, the sternal end of the sixth rib, and the aponeurosis of the external oblique of the anterior abdominal wall. The sternocostal head is the larger of the two heads and can have between two and seven distinct segments.

Question 18

What is the innervation of each rotor cuff muscles

Answer 18

Suprascapular nerve
Supplies the supraspinatus and infraspinatus muscles. The suprascapular nerve is a branch of the superior trunk of the brachial plexus and comes from C5-C6.
Axillary nerve
Supplies the teres minor muscle. The axillary nerve comes from the posterior cord of the brachial plexus and also comes from C5-C6.
Subscapular nerves
Supplies the subscapularis muscle. The subscapular nerves come from the posterior cord of the brachial plexus and come from C5-C7.

Question 19

What are the structures of the femoral sheath

Answer 19

Femoral artery, vein and femoral canal

Question 20

What are the boundaries of the posterior mediastinum and what are the contents

Answer 20

Lateral: Mediastinal pleura, which is part of the parietal pleural membrane
Anterior: Pericardium
Posterior: T5-T12 vertebrae
Roof: An imaginary line that extends from the sternal angle to the T4 vertebrae
Floor: Diaphragm

Aorta: Descending thoracic aorta
Veins: The azygos and hemiazygos veins
Lymphatics: The thoracic duct,
Nerves: The vagus, splanchnic, and sympathetic nerves
Esophagus: Runs vertically directly behind the left atrium
Bronchi: The bronchi branch off from the trachea in the middle mediastinum to form the right and left main bronch

Question 21

What is the blood supply of the oesophagus

Answer 21

The esophagus receives arterial blood from several arteries, including:

Thoracic esophagus: Branches of the thoracic aorta and the inferior thyroid artery, which is a branch of the thyrocervical trunk. The paired aortic esophageal arteries, or terminal branches of bronchial arteries, also supply the thoracic esophagus.

Abdominal esophagus: The left gastric artery, which is a branch of the coeliac trunk, and the left inferior phrenic artery supply the abdominal esophagus.

Venous drainage
The esophagus drains into the systemic circulation through branches of the azygous veins and the inferior thyroid vein. The abdominal esophagus has mixed venous drainage, with some draining to the portal circulation via the left gastric vein and some draining to the systemic circulation via the azygous vein

Question 22

What are the different types of suture material and what is the use

Answer 22

Vicryl: Vicryl is an absorbable braided suture material. Vicryl Plus lose 50% of their tensile strength within 3 weeks and are completely absorbed within 70 days. Vicryl Rapide loses 50% of its tensile strength within 5 days and is completely absorbed within about 40 days.

Monocryl: Monocryl is an absorbable monofilament suture material. It loses 50% of its tensile strength within about 1 week and is completely absorbed within 120 days.

PDS: PDS (officially known as PDS II) is an absorbable monofilament suture material. PDS is absorbed slowly by hydrolysis. It loses 50% of its tensile strength within 4 weeks but hardly breaks down during the first 90 days. It is completely absorbed within about 180 days.

Silk: Silk is a non-absorbable braided suture material, used for drains, Semi-permanent and hence used for drains and has excellent handling

Ethibond: Ethibond is a non-absorbable braided suture material. INdefinite

Nylon: non-absorbable monofilament suture material. Breaks down extremely slowly

Prolene: Prolene is a non-absorbable monofilament suture material made from polypropylene. Vascular anastomosis

Question 23

What vessels are behind the pancreatic head and neck

Answer 23

Behind the head, there is the IVC and renal vein
Behind the neck, there is the SMA and SMV

Question 24

What lies in front of D3 of the duodenum

Answer 24

The third segment runs from right to left in front of the aorta and inferior vena cava, with the superior mesenteric vessels in front of it.

Question 25

What are the bones that form the lateral arch of the foot

Answer 25

Lateral calcaneus, cuboid and the 4th and 5th metatarsal

Question 26

What are the lateral ligaments of the foot

Answer 26

anterior talofibular (ATFL), calcaneofibular (CFL), and posterior talofibular (PTFL) ligaments, which together make up the lateral ligament complex (LCL)

Question 27

What are the muscles of the anterior compartment of the leg

Answer 27

Tibialis anterior Ext Hal Lon Ext Dig Long Per tert

Question 28

What is the sustentaculum tali

Answer 28

a bony shelf which provides structural support for the talus and an attachment point for the plantar calcaneonavicular, or spring ligament

Question 29

What is the action of the subtalar joint and the talocrural joint

Answer 29

ST: side to side TC: up and down

Question 30

What type of joint is the distal tibiofibular joint

Answer 30

fibrous

Question 31

Which position if the ankle more stable in

Answer 31

Dorsiflexion as the talus is widest here

Question 32

What is the cell types of the oesophagus

Answer 32

Stratified squamous cells

Question 33

What is the deltoid ligament of the foot made up of

Answer 33

The superficial components: The tibiocalcaneal ligament The tibionavicular ligament The posterior superficial tibiotalar ligament passes posterolaterally to the medial side of the talus and its medial tubercle The tibiospring ligament descends vertically and blends with the fibres of the spring ligament The deep components: The anterior tibiotalar ligament (ATTL) posterior deep tibiotalar ligament (PDTL) tibiotalar and tibiocalcaneal ligaments

Question 34

What are the ligaments of the odontoid peg

Answer 34

Alar ligaments: These thick, fibrous bands attach the odontoid process to the occipital condyles. They prevent the head and atlas from rotating too much relative to the axis. The alar ligaments also limit flexion and axial rotation, and help stabilize the craniocervical junction. Transverse ligament of the atlas: This ligament runs behind the odontoid process and holds it in place. Cruciate ligament complex: This complex originates from the back of the odontoid peg and includes the superior and transverse ligaments. The transverse ligament is the strongest part of the complex.

Question 35

What are the borders of the adductor canal

Answer 35

Anteromedial – Sartorius. Lateral – Vastus medialis. Posterior – Adductor longus and adductor magnus.

Question 36

What is the origin, insertion and action of the quadratus femoris muscle

Answer 36

The quadratus femoris muscle originates from the upper part of the lateral margin of the ischial tuberosity, and inserts into the quadrate tubercle of the femur: Origin The quadratus femoris muscle originates from the lateral margin of the obturator ring, above the ischial tuberosity. Insertion The quadratus femoris muscle inserts into the quadrate tubercle and adjacent bone of the intertrochanteric crest of the proximal posterior femur. The quadratus femoris is a short, flat, quadrilateral muscle in the gluteal region of the lower limb. It's one of the deep gluteal muscles, located below the gemelli and obturator internus. The quadratus femoris muscle laterally rotates the thigh at the hip joint and helps to adduct the hip.

Question 37

What is the innervation of the omohyoid muscle with nerve roots

Answer 37

The superior belly of omohyoid muscle is innervated by the superior root of ansa cervicalis (C1), while the inferior belly receives fibers from spinal nerves C1, C2 and C3.

Question 38

What lies at the transpyloric plane

Answer 38

pylorus of the stomach D1 part of the duodenum duodeno-jejunal flexure root of the transverse mesocolon hepatic flexure of the colon splenic flexure of the colon fundus of the gallbladder neck of the pancreas hila of the kidneys hilum of the spleen ninth costal cartilage termination of spinal cord and superior portion of conus medullaris origin of superior mesenteric artery splenic vein joins superior mesenteric vein to form portal vein cisterna chyli

Question 39

What are the tributaries of the IVC

Answer 39

Renal veins: The right renal vein receives blood exclusively from the kidney, while the left renal vein receives blood from other organs as well. Hepatic veins: Two or three short hepatic trunks empty into the IVC as it passes through the diaphragm. Hepatic veins return low-oxygen blood from the liver back to the heart. Lumbar veins: These veins drain blood from various areas of the body, including the lumbar back and skin, and the anterior, posterior, and lateral abdominal walls. Right suprarenal vein: This vein terminates directly in the IVC. Right gonadal vein: This vein enters the IVC at the L2 vertebral level. Inferior phrenic veins: These veins enter the IVC at the T8 vertebral level. Right and left common iliac veins: These veins enter the IVC at the L5 vertebral level.Wh

Question 40

What is the anterior relation of the aorta

Answer 40

Stomach: The stomach is located directly in front of the aorta. Pancreas: The pancreas is located in front of the aorta. Duodenum: The descending part of the duodenum is related to the aorta. Mesentery: The root of the mesentery is related to the aorta. Small intestine: The small intestine is related to the aorta. Splenic vein: The splenic vein crosses the aorta anteriorly. Left renal vein: The left renal vein crosses the aorta anteriorly